Counselling and testing

In a world with HIV/AIDS, we should all know our HIV status. For those of us who are HIV-infected, it is important to be tested as early as possible, so that our doctor can monitor our health and begin therapy when it will be most effective. For those of us who are not HIV-infected, being tested can help reduce anxiety and provide an opportunity to personalize our own HIV-prevention plan with a trained counsellor.

Our test results will be kept confidential. The UN system will never require us to be tested for HIV, although it is highly recommended that all employees and their families do so voluntarily. Nor will we be required to disclose our HIV status to a supervisor or any other co-worker. The UN-system medical services can provide a list of reliable sources of HIV counselling and testing.

Until recently, taking the HIV test required a wait of several days for test results. In many medical settings and testing sites, health-care providers now use what is known as the 'rapid test', which yields highly accurate results in a matter of minutes.

Only you, of course, can assess your risk of infection. Studies among people living with HIV, however, consistently show that a large share of people living with HIV were unaware of their risk prior to their diagnosis. We should think of our HIV status as we would our blood pressure or cholesterol; knowing our HIV status is simply another way of protecting our health.

If any of us is thinking about being tested, we can take comfort in knowing that we are not the first. Getting tested for HIV can be a little scary. Each of us should know that a trained counsellor will be available to provide us with support and to answer any questions both before the test and when we receive our results. It is worth reminding ourselves that we can live with any result we get from the HIV test. Unlike earlier in the epidemic, when the prognosis was dire for a person who tested HIV-positive, it is possible today to live with the infection.

Depending on the level of your anxiety about receiving your test result, you might consider having a friend or loved one on standby to talk with you after you get your results. While your post-test counsellor will be available to calm your fears and offer you extensive information, it also helps to have a support network to help you work through your fears.

None of us need to be alone if we test HIV-positive. Millions of people throughout the world are living with HIV. HIV infection does, though, present important life challenges. Any of us who test HIV-positive should think about contacting a local AIDS service organization or the UN HIV/AIDS focal point in our country to obtain information about a support group to join. An increasing number of workplaces have their own support groups. By sharing our experiences with other people living with the disease, we can reduce our anxieties, learn new strategies for coping with HIV infection, and build new friendships with people who are facing similar challenges.

If you would like to speak confidentially to a UN HIV/AIDS counsellor outside your duty station, you may contact the UN staff counsellor's office in New York at [1-011] (212) 963-4782.

Can I keep my HIV status confidential? For those of us who are HIV-positive, it can be difficult to decide if, or when, to tell another person about our HIV status. It is only natural to worry about being rejected by family, friends, neighbours, or co-workers. Unfortunately, discrimination against people living with HIV remains all too common, so those of us who are HIV-positive should definitely give some thought to whom we feel we can trust with this information.

In general, most people with HIV find it helpful to disclose their HIV status to trusted friends and loved ones. An AIDS service organization can help us think about how best to disclose our status. By disclosing, those of us who are HIV-positive can benefit from the love, support and advice of people we trust. Having a strong social network is important to living positively with HIV.

Although, as employees of the UN system, we will never be made to disclose our HIV status to a supervisor or co-worker, there may be advantages to sharing this information with a trusted supervisor or other colleagues, such as human resource professionals. Disclosing our status may make it easier to be open and honest about why we may need to take time off for medical care, or why we need to work on a more flexible schedule. In the long run, keeping our HIV status a secret may cause stress and anxiety. In the end, though, whether or not we disclose our status is our decision alone.

None of us who work in the UN system can be fired, demoted, or denied a promotion or assignment solely on the basis of HIV infection. Most people with HIV are fully capable of continuing to contribute through work-whether within or outside the UN system. In the UN system, fitness to perform the required duties is the sole medical requirement for employment.

When we are placed in a new position in the UN or sent on mission, UN system medical services conduct a medical exam to determine our physical fitness for the assignment. Keep in mind that the UN system medical services will not test you for HIV without your consent. Depending on the nature of the assignment, its location, and the state of our own health, the UN system medical services might decline to certify us as being fit for a particular job. In all such cases, qualified medical staff will make this determination only after an individualized assessment of our health situation; no blanket exclusion of people with HIV is allowed for jobs in the UN. If a medical clearance is withheld for a new assignment, the UN system medical services will not disclose to your supervisor or your colleagues the nature of any health condition revealed or detected during a medical examination. The UN system medical services will, in all cases, closely guard the confidentiality of all personal medical information, including your HIV status, should you decide to disclose it to them.

If, at any time, you become unable to perform your job as a result of HIV infection, the UN system will work with you to adjust your work situation so that you can continue to be employed by the UN system.

For more explanations of the test, reasons to have a test, the specifics of clinical and home testing, and personal narratives, visit (pages will open in a new browser window):

• HIV Testing
  Information by AVERT.org, a UK based charity
• Frequently Asked Questions About Testing
  By the National HIV Testing Resources. Also available in Spanish.
• About HIV Testing
  By the American Federation of AIDS Research (AMFAR), available in English and Spanish
• HIV Testing
  By The Body: an AIDS and HIV Information Resource
• CDC Divisions of HIV/AIDS Prevention
  Testing services and information provided by the CDC, an American organization.